Active NPI
Adrian Rivera, OTR
- Occupational Therapist
- Staten Island, NY
National Provider Identifier
1306070487
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 010140-1
- Practice address
- 4300 Hylan Blvd
Staten Island, NY 10312-6505 - Phone
- (718) 984-3022
- Fax
- (718) 967-2073
- NPI assigned
- May 5, 2009
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 010140-1 | NY | Primary |
Addresses
Primary practice location
4300 Hylan Blvd
Staten Island, NY 10312-6505
Mailing address
16 Jacob Dr
Millstone TWP, NJ 08535-1210
Phone (732) 786-0058
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 010140-1 | NY | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1241481600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1241481600000",
"number": "1306070487",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "16 JACOB DR",
"city": "MILLSTONE TWP",
"state": "NJ",
"postal_code": "085351210",
"telephone_number": "732-786-0058",
"fax_number": "732-786-0058"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4300 HYLAN BLVD",
"city": "STATEN ISLAND",
"state": "NY",
"postal_code": "103126505",
"telephone_number": "718-984-3022",
"fax_number": "718-967-2073"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RIVERA",
"first_name": "ADRIAN",
"name_prefix": "Mr.",
"credential": "OTR",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2009-05-05",
"last_updated": "2009-05-05",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "NY",
"license": "010140-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Staten Island, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.